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HomeMy WebLinkAboutBuilding Permit Application SUPPLEM' ENTAL CONSTRUCTION LIEN LAW INFORMATION,: DESIGNER_/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: t x3,-e ) Name: Address: i_.6P 10 Address: City: Stater City: State: Zip: 4za:�� Phone .;- PJ Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review:room additions, accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent fo r� Signature of Contractor/License Holder t, •,, STATE OF FLORIDA STATE OF FLORIDA COUNTY OF �� � COUNTY OF Ll�ia✓e� `'' X�> m The forgoing instrument was acknowledge pefore �0 9 The forgoing instrument was acknowledged befor 6 X< this day of r�'1 20 by Q this I day of 20a by z m moo= cnCn Sazc d cnw Na erson making statement A-!9 Na of person making statement -n Personal mown OR Produced Identificati PersonaKnown OR Produced Identificat r 70 Type o de ion Type ion .�N Produced Produced (Signature of No y Public-State of Florida U (Signature of N Public-State of Florid) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Nu = OR` ECEI"' "E" ML 2 • Building Permit Applicati n MAY 01 2018 Planning and Development Services :Q:n ViD Building and Code Regulation Division Permitting Department 2300 Virginia Avenue,Fort Pierce FL 34982 t, LU c i e C t , FL 9 S y Phone: (772)462-1553 Fax: (772)462-1578 Commercial PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address:�4400 Pla#s ,t✓a.we_ , ��/�.Gt'Lc 3 yp 8 Legal Description: 9y-a Property Tax ID#: 2- -3 ©00 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: s CONSTRUCTION INFORMATION Additional work toe performed under this permit–check a appy: HVAC 11 Gas Tank ❑Gas Piping _Shutters Windows/Doors 0 Electric 0 Plumbing ❑Sprinklers El Generator Roof Roof pitch Total Sq. Ft of Construction: S Ft.of First Floor: Cost of Construction:$ J�o� Utilities:t Sewer LJ Septic Building Height: OWNER/LESSE,E: CONTRACTOR:; Name , i�✓L ,z[vw� Name: — Address: / Of o% S 44AA— Company:,/�a.v i ti��� on s�i2wa�,:►1� �. City: 4_1rf4c- 'k— State: l'l Address:�3a�" S, �y�,u� /Z, &u� Zip Code:_3,�(f �z Fax: City: FSP- eo e- State: Phone No. Zip Code: _3 V�d1L Fax: E-Mail: Phone No. 72y` a,z-Zg Fill in fee simple Title Holder on next page(if different E-Mail: LAO-, k--I-e � ��sa '�✓�� from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.